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Culturally adapting a mindfulness and acceptance-based intervention to support the mental health of adolescents on antiretroviral therapy in Uganda

The dual burden of living with HIV and negotiating life stage changes has been identified as a contributing factor to lapsed adherence among adolescents with HIV in sub-Saharan Africa. While psychosocial support can promote medication adherence, most interventions in use with adolescents were origin...

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Autores principales: Musanje, Khamisi, Camlin, Carol S., Kamya, Moses R., Vanderplasschen, Wouter, Louise Sinclair, Deborah, Getahun, Monica, Kirabo, Hope, Nangendo, Joan, Kiweewa, John, White, Ross G., Kasujja, Rosco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021405/
https://www.ncbi.nlm.nih.gov/pubmed/36963093
http://dx.doi.org/10.1371/journal.pgph.0001605
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author Musanje, Khamisi
Camlin, Carol S.
Kamya, Moses R.
Vanderplasschen, Wouter
Louise Sinclair, Deborah
Getahun, Monica
Kirabo, Hope
Nangendo, Joan
Kiweewa, John
White, Ross G.
Kasujja, Rosco
author_facet Musanje, Khamisi
Camlin, Carol S.
Kamya, Moses R.
Vanderplasschen, Wouter
Louise Sinclair, Deborah
Getahun, Monica
Kirabo, Hope
Nangendo, Joan
Kiweewa, John
White, Ross G.
Kasujja, Rosco
author_sort Musanje, Khamisi
collection PubMed
description The dual burden of living with HIV and negotiating life stage changes has been identified as a contributing factor to lapsed adherence among adolescents with HIV in sub-Saharan Africa. While psychosocial support can promote medication adherence, most interventions in use with adolescents were originally developed for the general population creating a gap in appropriate support. Life-stage-appropriate, evidence-based psychosocial support interventions have been used with young people in high-income contexts, prompting interest in their use in low-income contexts. However, many interventions are less effective when implemented outside of their original settings, hence the need for modifications before implementation. We aimed to culturally adapt an evidence-based psychosocial support intervention designed to improve the mental health of young people for use among adolescents with HIV in a sub-Saharan African context and to explore the acceptability of the adapted intervention among adolescents. We engaged thirty stakeholders (n = 30) in Kampala, Uganda including psychologists, psychiatrists, social workers, HIV counselors, religious leaders and adolescent peers from December 2021 to April 2022 to modify an evidence-based intervention for adolescents. Key adaptations included simplifying the language, adding local practices, integrating locally relevant slang and stories into therapy, introducing racially-congruent visuals and cards representing emotions, and adjusting therapy materials for use in resource-constrained settings. We then tested the acceptability of the intervention in a small sample of service users using a qualitative approach. We recruited nine adolescents with HIV from a participating clinic in Kampala, delivered six 90-minute sessions of the adapted intervention across three weeks and conducted in-depth interviews to assess the acceptability of the intervention. We used thematic analysis to analyze the qualitative data. The adapted intervention was perceived as acceptable among adolescents with HIV, with many stating that it helped them overcome fears, increased their self-acceptance, and gave them the confidence to make careful health-enhancing decisions.
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spelling pubmed-100214052023-03-17 Culturally adapting a mindfulness and acceptance-based intervention to support the mental health of adolescents on antiretroviral therapy in Uganda Musanje, Khamisi Camlin, Carol S. Kamya, Moses R. Vanderplasschen, Wouter Louise Sinclair, Deborah Getahun, Monica Kirabo, Hope Nangendo, Joan Kiweewa, John White, Ross G. Kasujja, Rosco PLOS Glob Public Health Research Article The dual burden of living with HIV and negotiating life stage changes has been identified as a contributing factor to lapsed adherence among adolescents with HIV in sub-Saharan Africa. While psychosocial support can promote medication adherence, most interventions in use with adolescents were originally developed for the general population creating a gap in appropriate support. Life-stage-appropriate, evidence-based psychosocial support interventions have been used with young people in high-income contexts, prompting interest in their use in low-income contexts. However, many interventions are less effective when implemented outside of their original settings, hence the need for modifications before implementation. We aimed to culturally adapt an evidence-based psychosocial support intervention designed to improve the mental health of young people for use among adolescents with HIV in a sub-Saharan African context and to explore the acceptability of the adapted intervention among adolescents. We engaged thirty stakeholders (n = 30) in Kampala, Uganda including psychologists, psychiatrists, social workers, HIV counselors, religious leaders and adolescent peers from December 2021 to April 2022 to modify an evidence-based intervention for adolescents. Key adaptations included simplifying the language, adding local practices, integrating locally relevant slang and stories into therapy, introducing racially-congruent visuals and cards representing emotions, and adjusting therapy materials for use in resource-constrained settings. We then tested the acceptability of the intervention in a small sample of service users using a qualitative approach. We recruited nine adolescents with HIV from a participating clinic in Kampala, delivered six 90-minute sessions of the adapted intervention across three weeks and conducted in-depth interviews to assess the acceptability of the intervention. We used thematic analysis to analyze the qualitative data. The adapted intervention was perceived as acceptable among adolescents with HIV, with many stating that it helped them overcome fears, increased their self-acceptance, and gave them the confidence to make careful health-enhancing decisions. Public Library of Science 2023-03-07 /pmc/articles/PMC10021405/ /pubmed/36963093 http://dx.doi.org/10.1371/journal.pgph.0001605 Text en https://creativecommons.org/publicdomain/zero/1.0/This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication.
spellingShingle Research Article
Musanje, Khamisi
Camlin, Carol S.
Kamya, Moses R.
Vanderplasschen, Wouter
Louise Sinclair, Deborah
Getahun, Monica
Kirabo, Hope
Nangendo, Joan
Kiweewa, John
White, Ross G.
Kasujja, Rosco
Culturally adapting a mindfulness and acceptance-based intervention to support the mental health of adolescents on antiretroviral therapy in Uganda
title Culturally adapting a mindfulness and acceptance-based intervention to support the mental health of adolescents on antiretroviral therapy in Uganda
title_full Culturally adapting a mindfulness and acceptance-based intervention to support the mental health of adolescents on antiretroviral therapy in Uganda
title_fullStr Culturally adapting a mindfulness and acceptance-based intervention to support the mental health of adolescents on antiretroviral therapy in Uganda
title_full_unstemmed Culturally adapting a mindfulness and acceptance-based intervention to support the mental health of adolescents on antiretroviral therapy in Uganda
title_short Culturally adapting a mindfulness and acceptance-based intervention to support the mental health of adolescents on antiretroviral therapy in Uganda
title_sort culturally adapting a mindfulness and acceptance-based intervention to support the mental health of adolescents on antiretroviral therapy in uganda
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021405/
https://www.ncbi.nlm.nih.gov/pubmed/36963093
http://dx.doi.org/10.1371/journal.pgph.0001605
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